Cochlear Implant Surgery: How to Fix Receiver/Stimulator Avoiding Extrusion:

Cochlear implant (CI) surgery is generally safe and associated with a limited number of complications, among which the extrusion of the receiver/stimulator (R/S) or the electrode misplacement and migration might require a CI re-implantation. The aim of this pilot study is to describe a new technique to firmly fix the R/S using the Mitek suture anchors system (Depuy Mitek Surgical Products, Inc. Raynham, Massachusetts). We tested two different models and in our experience, the web of suture created with this device can improve the stability of the bond of the R/S to the underlying curved bone surface. So, this system resulted in a less laborious manner keeping low the complication rate

The Diverticular Disease Registry (DDR Trial) by the Advanced International Mini-Invasive Surgery Academy Clinical Research Network: Protocol for a Multicenter, Prospective Observational Study

Diverticular disease is an increasingly common issue, with a variety of clinical presentations and treatment options. However, very few prospective cohort studies explore outcomes between the different presentations and treatments. The Diverticular Disease Registry (DDR Trial) is a multicenter, prospective, observational cohort study on behalf of the Advanced International Mini-Invasive Surgery (AIMS) academy clinical research network. The DDR Trial aims to investigate the short-term postoperative and long-term quality of life outcomes in patients undergoing surgery or medical treatments for diverticular disease. DDR Trial is open to participation by all tertiary-care hospitals. DDR Trial has been registered at ClinicalTriats.gou (NCT 04907383). Data collection will be recorded on Research Electronic Data Capture (REDCap) starting on June 1 , 2021 and will end after 5 years of recruitment. All adult patients with imaging-proven colonic diverticular disease (i.e., symptomatic colonic diverticulosis including diverticular bleeding, diverticulitis, and Symptomatic Uncomplicated Diverticular Disease) will be included. The primary outcome of DDR Trial is quality of life assessment at 12-month according to the Gastrointestinal Quality of Life Index (GIQLI). The secondary outcome is 30-day postoperative outcomes according to the Clavien-Dindo classification. DDR Trial will significantly advance in identifying the optimal care for patients with diverticular disease by exploring outcomes of different presentations and treatments

Cochlear Implant Surgery: How to Fix Receiver/Stimulator Avoiding Extrusion

Cochlear implant (CI) surgery is generally safe and associated with a limited number of complications, among which the extrusion of the receiver/stimulator (R/S) or the electrode misplacement and migration might require a CI re-implantation. The aim of this pilot study is to describe a new technique to firmly fix the R/S using the Mitek suture anchors system (Depuy Mitek Surgical Products, Inc. Raynham, Massachusetts). We tested two different models and in our experience, the web of suture created with this device can improve the stability of the bond of the R/S to the underlying curved bone surface. So, this system resulted in a less laborious manner keeping low the complication rate

A rare case of endolymphatic sac hemangioma in a patient alleged to have M\ue9ni\ue8re's disease

A rare case of endolymphatic sac hemangioma; description in a patient alleged to have Meniere diseas

Totally laparoscopic total gastrectomy: challenging but feasible: a single center case series

Aim: To report the initial monocentric experience of totally laparoscopic total gastrectomy, assessing its feasibility and safety, especially relating to the challenging step of esophago-jejunal (E-J) reconstruction.Methods: All consecutive patients, underwent laparoscopic total gastrectomy for gastric cancer with curative intent, between January 2017 and June 2018 at our institution, were considered. Data of the selected patients was retrieved from a prospectively collected database. Short and long term outcomes were analyzed.Results: Ten patients underwent totally laparoscopic total gastrectomy with D2 lymphadenectomy and 4 of these had received preoperative chemotherapy; Two patients also received the lymphadenectomy of the station 10. E-J reconstruction consisted of hemi-double stapling technique with transorally inserted anvil in 1 case, side-to-side overlap anastomosis in 5 cases and end-to-side anastomosis in 4 cases. One patient experienced intraoperative complications needing conversion to laparotomy. Seven patients experienced postoperative complications, three of these were severe according to Dindo-Clavien classification. All the specimens had free proximal resection margins with R0 resection in all the cases. Average postoperative length of hospital stay was 10 days and no patients died during hospitalization. Median overall survival and disease-free survival were 15.5 and 12.5 months respectively.Conclusion: Totally laparoscopic total gastrectomy is a feasible and safe option in the treatment of gastric cancer. The choice about the type of E-J reconstruction should be based on the single patient’s features and on the dexterity of the surgeon who should be able to perform more than one option for a tailored approach

Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic aneurysms and massive splenic infarction: a case report

Abstract Background The burden of disease caused by Streptococcus agalactiae has increased significantly among older adults in the last decades. Group B streptococcus infection can be associated with invasive disease and severe clinical syndromes, such as meningitis and endocarditis. Case presentation We present the case of a 56-year-old man who developed multiple mycotic aneurysms of the right hepatic artery and massive splenic infarction as rare complications of Streptococcus agalactiae infective endocarditis. The patient underwent urgent right hepatic artery ligation and splenectomy. The postoperative course was complicated by an episode of hemobilia due to the rupture of a partially thrombosed mycotic aneurysm into the biliary tree. Thus, selective radiological embolization of the left hepatic artery branches was necessary. Conclusion To our knowledge, this is the first case reported of infected aneurysms of visceral arteries caused by Group B streptococcus infection. Clinical and laboratory findings were non-specific, while imaging features with computed tomography scan and angiography were highly suggestive. In our case, early recognition, culture-specific intravenous antibiotics and urgent surgical treatment combined with interventional radiology played a decisive role in the final result

New lipophilic glycomimetic DC-SIGN ligands: Stereoselective synthesis and SPR-based binding inhibition assays

International audienceThe design and synthesis of efficient ligands for DC-SIGN is a topic of high interest, because this C-type lectin has been implicated in the early stages of many infection processes. DC-SIGN membrane-protein presents four carbohydrate-binding domains (CRD) that specifically recognize mannose and fucose. Therefore, antagonists of minimal disaccharide epitope Manα(1,2)Man, represent potentially interesting antibacterial and antiviral agents. In the recent past, we were able to develop efficient antagonists, mimics of the natural moiety, characterized by the presence of a real d-carbamannose unit which confers greater stability to enzymatic breakdown than the corresponding natural disaccharide ligand. Herein, we present the challenging stereoselective synthesis of four new amino or azide glycomimetic DC-SIGN antagonists with attractive orthogonal lipophilic substituents in C(3), C(4) or C(6) positions of the real carba unit, which were expected to establish crucial interactions with lipophilic areas of DC-SIGN CRD. The activity of the new ligands was evaluated by SPR binding inhibition assays. The interesting results obtained, allow to acquire important information about the influence of the lipophilic substituents present in specific positions of the carba scaffold. Furthermore, C(6) benzyl C(4) tosylamide pseudodisaccharide displayed a good affinity for DC-SIGN with a more favorable IC50 value than those of the previously described real carba-analogues. This study provides valuable knowledge for the implementation of further structural modifications towards improved inhibitors